`Training in Community Living': an alternative to the psychiatric hospital?
`Training in Community Living' is a well-researched alternative to the mental hospital. Its positive results have been replicated at five different sites. The program is the keystone element in a comprehensive system of care for the mentally ill in Dane County (Wisconsin, USA). Assertive outreach, clinical case management, availability of crisis resolution, coordination and utilization of a wide variety of community resources and `gatekeeping' by a responsible unit are some of the important elements of this approach, that supports patients in the community, rather than to prepare them for the community. To make such a community-based program possible, a change is required in mental health funding and legislation. Community support programs for the chronically mentally ill confront ethical problems that are different from those faced by other areas of psychiatry.